Youth Top Problems
(TP; Weisz et al., 2011).
The TP is an idiographic assessment measure designed to identify important problems related to functioning and symptoms (e.g., “My mom and I argue a lot”) at the beginning of treatment, and track the severity of these problems over the course of treatment. Thus, it is best described as a treatment monitoring and evaluation tool. At the beginning of treatment, the caregiver and youth work with their clinician to identify all problems of concern. After getting a complete list of the problems, the clinician and family rate each listed problem in terms of “how big a problem it is for the youth/caregiver” from one (“Not at all”) to 10 (“Very, very much”). After creating this comprehensive list with associated severity ratings, the caregiver and youth identify “Which problem is the biggest problem right now? Which of these is giving you [or youth’s name] the most trouble right now? Which one is the most important to work on?” (Weisz et al., 2011). The top three problems become the TP measure that is used throughout treatment. Each week, the caregiver and youth re-rate these top three problems on the same one to ten scales. To assess psychometric properties, the TP was coded and compared to the CBCL (Achenbach & Rescorla, 2001) and the YSR (Achenbach, 1991b) scores throughout treatment. Speaking to this measure’s relevancy to clinical work, 95.7% of the caregiver-identified problems and 97.9% of the youth-identified problems matched a CBCL item or YSR item, respectively (Weisz et al., 2011). The TP demonstrates adequate test-retest reliability over a period of one week (α= .69 to .91; Weisz et al., 2011). This measure is sensitive to change over time (Weisz et al., 2011). Since this is an idiographic measure, a form is not available per se, but clinicians are welcome to follow the procedure outlined about to create their own version for clients.
Trauma
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